ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI (EIN 81-2240617)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202203159349307555
- Schema version
- 2021v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T16:03:44-08:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 800519547 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ACCOUNTANCY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N Brand Blvd Fl 20 | AddressLine1Txt |
| City | Glendale | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 812240617 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adventist Health Medical Ctr Tehachapi | BusinessNameLine1Txt |
| Business Name Line2 | dba Adventist Health Tehachapi Valley | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 6618233000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 Magellan Dr | AddressLine1Txt |
| City | Tehachapi | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93561 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Shane Cox | PersonNm |
| Person Title | Finance Officer | PersonTitleTxt |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Shane | PersonFirstNm |
| Person Last | Cox | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | S Clement | PreparerPersonNm |
| PTIN | P01218012 | PTIN |
| Phone | 8185475701 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Wolcott Daniel | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 Magellan Dr | AddressLine1Txt |
| City | Tehachapi | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 935611380 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $59,863,269 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.adventisthealth.org/tehachapi-valley | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2016 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Living Gods love by inspiring health, wholeness and hope. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 345 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $724,939 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,236,672 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,774,654 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $58,083,801 | CYProgramServiceRevenueAmt |
| PY Investment Income | $298,028 | PYInvestmentIncomeAmt |
| CY Investment Income | $542,796 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $48,797,621 | PYTotalRevenueAmt |
| CY Total Revenue | $59,863,269 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $76,983 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $50,650 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,101,246 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,251,844 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $197,385 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,997,516 | PYOtherExpensesAmt |
| CY Other Expenses | $30,680,579 | CYOtherExpensesAmt |
| PY Total Expenses | $43,175,745 | PYTotalExpensesAmt |
| CY Total Expenses | $51,983,073 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,621,876 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,880,196 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $66,701,688 | TotalAssetsBOYAmt |
| Total Assets EOY | $73,073,972 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $70,263,102 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $73,329,590 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,561,414 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$255,618 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Living Gods love by inspiring health, wholeness and hope. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $39,739,698 | ExpenseAmt |
| Grant | $50,650 | GrantAmt |
| Revenue | $59,863,269 | RevenueAmt |
| Desc | Adventist Health Medical Ctr Tehachapi (AHTV) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay.Although reimbursement for services rendered is critical to the operation and stability Adventist Health Medical Ctr Tehachapi, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at below costproviding health/wellness activities and community education programsNot only does Adventist Health Medical Ctr Tehachapi provide low cost care to individuals covered by government-programs and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits.AHTV recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2021 was $3,783,542.The following Inpatient services that were provided to all our patients. These services included:87 Surgeries performed6,017 Patient days The following Outpatient services that were provided to all our patients. These services included:19,014 Emergency department visits243 Outpatient surgeries performed13,185 Outpatient visits 16,989 Clinic visitsAHTV recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2021 was $403,502.Adventist Healths mission statement of Living Gods love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry as represented by the life of Jesus Christ and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs and inner cities we serve, we continue our journey to provide quality healthcare until every person made in Gods image has experienced the best health today, hope for tomorrow, and Gods love that endures forever.Website for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ | Desc |
| Total Program Service Expenses | $39,739,698 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 345 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Beaman | PersonNm |
| Phone | 9164061092 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 619135 | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Reiner Scott | |||||||
| CEO thru 12/21 | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $2,940,088 | $62,418 |
| Wing Bill | |||||||
| Dir/Asst Sec/VC | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $2,459,079 | $76,222 |
| Jahn Andrew | |||||||
| President, Care Division | 2.00 | 48.00 | $0 | $1,848,683 | $72,937 | ||
| Hofheins Todd | |||||||
| CFO | 0.00 | 50.00 | Yes (X) | $0 | $1,319,147 | $59,910 | |
| Nahapetian Arby | |||||||
| Care Division Chief Medical Officer | 2.00 | 48.00 | $0 | $1,058,113 | $78,302 | ||
| Eller Jeff | |||||||
| Vice Chair/AHTV | 0.00 | 50.00 | $0 | $1,100,138 | $22,996 | ||
| Wolcott Daniel | |||||||
| Pres thru 3/21 | 0.00 | 50.00 | Yes (X) | $0 | $932,279 | $72,937 | |
| Jobe Meredith | |||||||
| Secretary | 0.00 | 50.00 | Yes (X) | $0 | $932,705 | $59,761 | |
| Larsen David | |||||||
| Finance Officer, CCR thru 4/19 | 0.00 | 50.00 | $0 | $876,757 | $67,250 | ||
| Stevens Eric | |||||||
| Care Division Operations Executive | 2.00 | 48.00 | $0 | $884,611 | $49,992 | ||
| Chen Steven | |||||||
| Former Finance Officer, CCR 2/20 | 0.00 | 50.00 | $0 | $779,689 | $73,789 | ||
| Spenst Brett | |||||||
| Care Division Finance Officer | 2.00 | 48.00 | $0 | $786,101 | $45,300 | ||
| Butler David | |||||||
| Pres eff 3/21 | 15.00 | 35.00 | Yes (X) | $0 | $680,823 | $72,937 | |
| Ferch Wayne | |||||||
| Former President, CCR thru 2/20 | 0.00 | 0.00 | $0 | $586,112 | $18,351 | ||
| Cox Shane | |||||||
| Treas/A Sec | 15.00 | 35.00 | Yes (X) | $0 | $504,779 | $83,596 | |
| Briggs Sharlet | |||||||
| President thru 08/20 | 0.00 | 0.00 | $0 | $548,135 | $32,738 | ||
| Cantrell Misty | |||||||
| Patient Care Executive | 50.00 | 0.00 | $0 | $401,495 | $97,156 | ||
| Reynoso Hernandez R | |||||||
| Former Medical Officer, CCR | 0.00 | 0.00 | $0 | $386,566 | $26,849 | ||
| Badders Brett | |||||||
| Manager, RN | 50.00 | 0.00 | $351,880 | $0 | $5,570 | ||
| Heinrich Kerry-CEO Elect1121 | |||||||
| Director | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $282,697 | $2,627 |
| Lorenz Alida | |||||||
| Director, RN | 50.00 | 0.00 | $187,444 | $0 | $45,074 | ||
| Guirguis Yehia | |||||||
| Pharmacist | 50.00 | 0.00 | $186,002 | $0 | $15,922 | ||
| Malas Nisreen | |||||||
| Supvsr, Pharmacy | 50.00 | 0.00 | $178,920 | $0 | $20,048 | ||
| Waterhouse Karla | |||||||
| RN, House Supvsr | 50.00 | 0.00 | $187,849 | $0 | $9,771 | ||
| Reppert Joseph | |||||||
| Former CFO/Asst Secr thru 8/19 | 0.00 | 0.00 | $0 | $179,119 | $11,442 | ||
| Jamaleddine Ghassan | |||||||
| Medical Officer as of 08/21 | 50.00 | 0.00 | $0 | $182,605 | $3,746 | ||
| Freedman John | |||||||
| VC/Chair 8/21 | 0.00 | 4.00 | Yes (X) | Yes (X) | $0 | $26,435 | $0 |
| Banks David | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Cherry Robert | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Davis Andrew | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Innocent Larry | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Reiner Richard | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Graham Ricardo | |||||||
| Chair thru 8/21 | 0.00 | 4.00 | Yes (X) | Yes (X) | $0 | $19,545 | $0 |
| Woodson Marc | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $15,909 | $0 | |
| Salazar Velino | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $6,058 | $0 | |
| Ocampo Lucy | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $159 | $0 | |
| Fehr Joy | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $114 | $0 | |
| Newton Bradford | |||||||
| Dir/VChair 8/21 | 0.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,092,095 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $19,868,736 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,187,641 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 601 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Healthcare Construction Company Inc | |||||
| 1125 Camino Del Mar Ste G | Del Mar | CA | 92014 | Design Services | $1,069,997 |
| Sound Physicians of California III | |||||
| PO Box 742936 | Los Angeles | CA | 90074 | Physician Services | $838,817 |
| GE Precision Healthcare LLC | |||||
| PO Box 96483 | Chicago | IL | 60693 | Physician Services | $777,600 |
| Fastaff LLC | |||||
| PO Box 911452 | Denver | CO | 80291 | Physician Services | $742,009 |
| John R Garcia MD Inc | |||||
| 8311 Brimhall Rd Bldg 1900 Ste 1901 | Bakersfield | CA | 93390 | Medical Services | $740,215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,236,672 | AllOtherContributionsAmt |
| Total Contributions | $1,236,672 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CARES Act Income | 900099 | $5,154,032 | $5,154,032 |
| Dietary/Cafeteria Revenue | $97,719 | $97,719 | |
| Other Program Services | $506,710 | $506,710 | |
| Patient Care Services | 900099 | $52,137,759 | $52,137,759 |
| Pharmacy Revence | $99,809 | $99,809 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,772 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $87,772 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $58,083,801 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $542,796 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $542,796 | RelatedOrExemptFuncIncomeAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,863,269 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $58,626,597 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,650 | TotalAmt |
| Program Services | $50,650 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,497,386 | TotalAmt |
| Program Services | $14,797,121 | ProgramServicesAmt |
| Management And General | $2,574,872 | ManagementAndGeneralAmt |
| Fundraising | $125,393 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $512,332 | TotalAmt |
| Program Services | $444,898 | ProgramServicesAmt |
| Management And General | $63,550 | ManagementAndGeneralAmt |
| Fundraising | $3,884 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,132,576 | TotalAmt |
| Program Services | $1,678,644 | ProgramServicesAmt |
| Management And General | $435,291 | ManagementAndGeneralAmt |
| Fundraising | $18,641 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,109,550 | TotalAmt |
| Program Services | $1,012,257 | ProgramServicesAmt |
| Management And General | $88,134 | ManagementAndGeneralAmt |
| Fundraising | $9,159 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,398,199 | TotalAmt |
| Program Services | $9,523 | ProgramServicesAmt |
| Management And General | $5,388,676 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,014 | TotalAmt |
| Management And General | $182,014 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,807,200 | TotalAmt |
| Program Services | $9,021,483 | ProgramServicesAmt |
| Management And General | $1,756,346 | ManagementAndGeneralAmt |
| Fundraising | $29,371 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,832 | TotalAmt |
| Management And General | $24,832 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,166 | TotalAmt |
| Program Services | $209,542 | ProgramServicesAmt |
| Management And General | $99,872 | ManagementAndGeneralAmt |
| Fundraising | $6,752 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,689,740 | TotalAmt |
| Program Services | $556,107 | ProgramServicesAmt |
| Management And General | $1,133,633 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,294,438 | TotalAmt |
| Program Services | $1,256,446 | ProgramServicesAmt |
| Management And General | $37,992 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,563 | TotalAmt |
| Program Services | $162,170 | ProgramServicesAmt |
| Management And General | $8,461 | ManagementAndGeneralAmt |
| Fundraising | $2,932 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,946 | TotalAmt |
| Program Services | $4,148 | ProgramServicesAmt |
| Management And General | $3,504 | ManagementAndGeneralAmt |
| Fundraising | $294 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,784,423 | TotalAmt |
| Program Services | $1,784,423 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,142,877 | TotalAmt |
| Program Services | $2,114,055 | ProgramServicesAmt |
| Management And General | $28,822 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,309 | TotalAmt |
| Program Services | $153,309 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Patient Care Supplies | $5,382,730 | $5,372,418 | $10,235 | $77 |
| Other Expenses | $587,910 | $377,272 | $209,756 | $882 |
| Quality Assurance | $486,267 | $486,267 | ||
| Equipment Rentals | $248,965 | $248,965 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,983,073 | TotalAmt |
| Program Services | $39,739,698 | ProgramServicesAmt |
| Management And General | $12,045,990 | ManagementAndGeneralAmt |
| Fundraising | $197,385 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,394,076 | BOYAmt |
| EOY | $18,568,952 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,477 | BOYAmt |
| EOY | $142,935 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,230,801 | BOYAmt |
| EOY | $5,992,822 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,957 | BOYAmt |
| EOY | $1,056,671 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,126 | BOYAmt |
| EOY | $60,850 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $48,496,998 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,290,273 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,088,813 | BOYAmt |
| EOY | $42,206,725 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,400 | BOYAmt |
| EOY | $111,836 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,949,038 | BOYAmt |
| EOY | $4,933,181 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,701,688 | BOYAmt |
| EOY | $73,073,972 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,937,142 | BOYAmt |
| EOY | $6,016,577 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,903 | BOYAmt |
| EOY | $531,504 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,323,057 | BOYAmt |
| EOY | $66,781,509 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,263,102 | BOYAmt |
| EOY | $73,329,590 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,056,595 | BOYAmt |
| EOY | -$2,312,542 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,495,181 | BOYAmt |
| EOY | $2,056,924 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,561,414 | BOYAmt |
| EOY | -$255,618 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,701,688 | BOYAmt |
| EOY | $73,073,972 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,880,196 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$4,469,501 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$104,899 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $4,553 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,553 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part II-B, Line 1i - Other Activities Description | The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. |
| Part IV - Additional Information |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,505,161 | BeginningYearBalanceAmt |
| Contributions | $1,536,692 | ContributionsAmt |
| Investment Earnings Or Losses | $5,118 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $980,048 | OtherExpendituresAmt |
| End Year Balance | $2,066,923 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $850,442 | BeginningYearBalanceAmt |
| Contributions | $724,919 | ContributionsAmt |
| Grants Or Scholarships | $16,851 | GrantsOrScholarshipsAmt |
| Other Expenditures | $53,349 | OtherExpendituresAmt |
| End Year Balance | $1,505,161 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $478,293 | BeginningYearBalanceAmt |
| Contributions | $725,438 | ContributionsAmt |
| Other Expenditures | $353,289 | OtherExpendituresAmt |
| End Year Balance | $850,442 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $225,090 | BeginningYearBalanceAmt |
| Contributions | $253,203 | ContributionsAmt |
| End Year Balance | $478,293 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $100,125 | BeginningYearBalanceAmt |
| Contributions | $124,965 | ContributionsAmt |
| End Year Balance | $225,090 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,300 | OtherCostOrOtherBasisAmt |
| Book Value | $114,300 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,252,314 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,113,751 | DepreciationAmt |
| Book Value | $37,138,563 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,675 | OtherCostOrOtherBasisAmt |
| Book Value | $72,675 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,057,709 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,176,522 | DepreciationAmt |
| Book Value | $4,881,187 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $42,206,725 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other Assets | $41,660 |
| Other Receivables | $909,145 |
| Receivables from related organizations | $70,990 |
| Receivables from Third Parties | $3,911,386 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,933,181 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Other Liabilities | $590,971 |
| Payables to 3rd Parties Medicare | $2,634,866 |
| Payables to Related Organizations | $63,555,672 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $66,781,509 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: Intended uses of the endowment fund. | Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. |
| Part X : FIN48 Footnote | The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2021 and 2020, no such assets or liabilities were recorded.The System currently files Form 990 (informational return of organizations exempt from income taxes) and form 990-T (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2017 in major tax jurisdictions. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $141,145 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $141,145 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,629,584 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,987,187 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,642,397 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,770,729 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,987,187 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,783,542 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07280 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $71,203 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $71,203 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $324,612 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $324,612 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,687 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,687 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $403,502 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $403,502 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,174,231 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,987,187 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,187,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08050 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,118,295 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $126,440 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,761,545 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,796,074 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,034,529 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adv Hlth Med Ctr Tehachapi | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 Magellan Dr | AddressLine1Txt |
| City | Tehachapi | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93561 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | See Form 990, Pg 1, Item J | WebsiteAddressTxt |
| State License | 120000188 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Sch H Part VI - Needs Assessment | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Sch H Part VI - Needs Assessment | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Sch H Part VI - Needs Assessment | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Sch H Part VI-Patient Education | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Sch H Part VI-Patient Education | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Sch H Part VI-Patient Education | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility: - Part V, Section B, Line 5 | The 2019 CHNA data collection process can be summarized as follows: 1. review of prior CHNA reporting efforts; 2. collection of most recently available demographic, socioeconomic and health indicator data; 3. Data gathering from community members. Community Survey: The Kern County Community Benefit Collaborative hospital representatives developed a plan for distribution of a survey to engage community residents. The survey was available in an electronic format through a Survey Monkey link, and in a paper copy format. The electronic and paper surveys were available in English and Spanish. The surveys were available from November 2018 to January 2019 and during this time, 1,114 usable surveys were collected. The hospitals distributed the surveys to their clients, in hospital waiting rooms and service sites, and through social media, including posting the survey link on hospital Facebook pages. The survey was also distributed to community partners who made them available to their clients. A written introduction to the survey questions explained the purpose of the survey and assured participants the survey was voluntary, and that they would remain anonymous. For community members who were illiterate, an agency staff member read the survey introduction and questions to the client in his/her preferred language and marked his/her responses on the survey. The survey included the following: demographics, biggest health issues in the community, greatest needs facing children and families, where residents and their families receive routine health care services, problems faced accessing health care, mental health care, dental care or supportive services, what would make it easier to obtain care, types of support or services needed in the community, and safety concerns in the community.Targeted Interviews: Interviews were used to gather information and opinions, by phone, from persons who represent the community served by the hospital. Interview participants were asked to share their perspectives on a number of topics related to the identified preliminary health needs in the community area. Given shared community areas, the Kern County Community Benefit Adventist Health Bakersfield 14 Collaborative hospitals worked together to conduct the interviews. Forty-one (41) interviews were completed from October 2018 through March 2019. Secondary data were collected from a variety of local, county and state sources to present a community profile, social determinants of health, health care access, birth indicators, leading causes of death, acute and chronic disease, health behaviors, mental health, substance use and misuse, and preventive practices. When available, data sets are presented in the context of Kern County and California to help frame the scope of an issue, as it relates to the broader community. Sources of data include: the U.S. Census American Community Survey, California Department of Public Health, California Health Interview Survey, Kern County Public Health Department, Healthy Kern County, County Health Rankings, California Department of Education, California Office of Statewide Health Planning and Development and California Department of Justice, among others. |
| Facility: - Part V, Section B, Line 6a | The Kern County Community Benefit Collaborative convened area hospitals and included these partners:Adventist Health Bakersfield and Adventist Health Tehachapi Valley Hospitals, Delano Regional Medical Center, Dignity Health Bakersfield, Mercy and Memorial Hospitals, Kaiser Permanente Kern County, Kern Medical, and Valley Children's Healthcare. |
| Facility: - Part V, Section B, Line 11 | The COVID-19 global pandemic has caused extraordinary challenges for Adventist Health hospitals and health care systems across the world including keeping front line workers safe, shortages of protective equipment, limited ICU bed space and developing testing protocols. They have also focused on helping patients and families deal with the isolation needed to stop the spread of the virus, and more recently vaccine roll out efforts. Adventist Health, like other health care systems, had to pivot its focus to meet the most urgent healthcare needs of its community during the pandemic, as well as reassess the ability to continue with some community health strategies due public health guidelines for social distancing. Adjustments have been made to continue community health improvement efforts as possible, while ensuring the health and safety of those participating. Our 2019 CHNA identified six areas of significant need: Chronic Diseases, Food Insecurity, Preventative Practices, Violence and Injury, Housing and Homelessness, and Economic Insecurity. Priority Need 1- Chronic Diseases- The goal is to reduce the impact of chronic diseases in at-risk communities, increase prevention and awareness. Strategy 1- Increase prevention and awareness activities in targeted zip codes. Activity 1.1- Provide screening for cholesterol, blood glucose, BMI, blood pressure at various health fairs, including a senior health and wellness fair on the AH Tehachapi campus and at the Tehachapi Downtown Farmers Markets & Activity 1.2- Provide cancer-related screening and preventative practice information at a variety of health fairs and community events. Our collective community impact includes the following: screened over 90 children in Mojave and California City by providing sport physicals and health screening assessments; collaborated with the Tehachapi Farmers Market by providing vaccines, screenings, behavioral health and healthy eating habit education to over 5,000 community members; provided both cancer screenings and colon cancer testing kits to over 100 community members, as well as provided breast cancer education for home and on-going preventive care; provided over 200 cholesterol screenings; provided over 100 encounters with information regarding healthcare prevention and behavioral health resources; provided 75 community members with information discussing substance abuse and addiction therapy reduction strategies, as well as information on key drivers of mental health conditions and substance abuse. Priority Need 2- Food Insecurity- The goal is to reduce surplus food waste and improve distribution to those in need. Strategy 1- Partner with Kern Public Health Waste Hunger Not Food to take edible, surplus food to distribute to those in need. Activity 1.1- Partner with Kern Public Health Waste Hunger Not Food to recover leftover hospital caf food and transport/redirect to local churches for distribution- Through 2021, we continued to collaborate and build relationships to provide resources to food insecure community members. Activities included food boxes for senior citizens, information and education to local sourcing programs, and partnered with College Community Services and Community Action Partnership of Kern County to provide free food disbursement and enrollment assistance to participants who identified as food insecure. Priority Need 3- Preventative Practices- The goal is to reduce the rate of unvaccinated and under vaccinated kids ages 0-5 and decrease the risk for outbreaks of vaccine-preventable diseases throughout the community. Strategy 1- Utilize grant funding to provide free flu and childhood immunizations to Kern County residents through a specially equipped mobile unit and provide COVID and Flu vaccinations to Kern County residents through a specially equipped mobile van. Activity 1.1- Mobile Unit- Our mobile unit launched in 2021 and provided primary care services in Tehachapi. Due to outreach and increase of access to care services were provided to rural areas within the county. The pediatric immunization program provided vaccine services to elementary school children. Additionally, the COVID mobile vaccine program provided over 5,000 vaccines. Priority Need 4- Violence and Injury- The goal is to implement research-informed communication efforts designed to prevent suicide by changing knowledge, attitudes, and behaviors. Strategy 1- Hold Question, Persuade, refer (QPR) Training to provide common suicide myths and facts; warning signs of suicide, tips for asking the suicide question, methods for persuading suicidal individuals to get help, and how to refer at-risk people for help. Activity 1.1- Behavioral Health Integration Incentive Program- We enrolled over one-hundred and fifty patients into the behavioral health program addressing mental health and substance abuse disorders. Throughout the year, we hosted 10 behavioral health presentations throughout East Kern County, with 15% of people enrolled seeing an increase in overall wellness.Priority Need 5- Housing and Homelessness- The goal is to work hand-in-hand with community partners to deliver a metric-driven strategy to reduce chronic homelessness across the county. Strategy 1- Partner with existing organizations in Kern County to support accurate homeless counts, data sharing and grant funding opportunities. Activity 1.1- Adventist Health to provide financial and volunteer support for the annual Point-In-Time (PIT) Count, Activity 1.2- Participation in Kern County Homeless Task Force, with an Adventist Health Bakersfield focus on sharing data and metrics- The Bakersfield-Kern Regional Homeless Collaborative (BKRHC) in partnership with Adventist Health sponsoring the Point in time count, also known as the Bakersfield/Kern County Continuum of Care (COC) CA-604, completed the annual 2021 Point-in-Time Count following guidance from the U.S. Department of Housing and Urban Development (HUD) for those who are sheltered and unsheltered. There was a total of 2,150 unduplicated persons sleeping in shelters and unsheltered on January 27, 2021. The PIT Count resulted in 569 persons who were sleeping in shelters and 1,581 who were unsheltered. Adventist Health launched the homeless prevention and homeless ESG grant program in the fall of 2021. The program screened patients, aligned patients with rapid re-housing and hotel stays to vulnerable patients. The program offers case management services to assist in the process of finding permeant housing solutions along with emergent housing.Priority Need 6- Economic Insecurity- The goal is to improve the social and physical well-being of its residents by decreasing barriers to employment. Strategy 1- Support efforts to reduce barriers to employment for those recently released from incarceration. Strategy 2- Align community work to include well-being related to economic security. Activity 1.1- Provide administrative and volunteer staff for a medical tattoo removal program with Garden Pathways- Adventist Health Tehachapi partnered with Garden Pathways to align recently released inmates to job retraining programs. Over 150 were seen in the tattoo removal program to remove employment barriers and sigmatisms around tattoos. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Adventist Health Community Care-California City | ||||
| 9350 North Loop Blvd | California City | CA | 93505 | Rural Health Clinic |
| Adventist Health Community Care-Mojave | ||||
| 2041 Belshaw Street | Mojave | CA | 93501 | Rural Health Clinic |
| Adventist Health Community Care-Tehachapi | ||||
| 105 West E Street | Tehachapi | CA | 93561 | Rural Health Clinic |
| Adventist Health Outpatient Physical Therapy | ||||
| 116 W F St | Tehachapi | CA | 93561 | Outpatient Physical Therapy |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7 - Explanation of Costing Methodology | The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income)/Gross patient chargesAdventist Health Tehachapi is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government. |
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio is multiplied times the hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. |
| Part III, Line 4 - Bad Debt Expense | The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments too many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information please refer to schedule H part III section B. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low incomeX and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest |
| Part VI, Line 2 - Needs Assessment | The hospital's 2019 CHNA, the 2022 Community Health Plan (CHP) Update for fiscal year 2021, and the 2020 Implementation Strategy adopted in 2020 are posted on the hospital's website at Community Benefit | Roseville, California | Adventist Health. The two most recent Community Health Needs Assessment, two most recent Implementation Strategy reports and the most recent Community Health Plan Update are also available on the Adventist Health Corporate website at Community Benefit | Roseville, California | Adventist Health. The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, our hospitals support local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of the regions we serve. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. |
| Part VI, Line 3 - Patient Education of Eligibility for Assistance | The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the hospital's website at https://www.adventisthealth.org/documents/financial-assistance/ENG_PFS-112_Financial-Assistance-Policy.pdf. These documents are available in multiple languages.At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. |
| Part VI, Line 4 - Community Information | The Tehachapi Valley community is located in the mountains of Eastern Kern County, California. The areas of service for Adventist Health Tehachapi Valley include: Tehachapi, Bear Valley, Golden Hills, Alpine, California City, Mojave, Rosamond, Boron and Edwards. The population of the Adventist Health Tehachapi Valley (AHTV) service area is 56,177. Population density is 93.76 people per square mile, compared to 107.15 persons per square mile in Kern County. Of the area population, 55.9% are male and 44.1% are female. Children and youth, ages 0-17, make up 23.1% of the population, 62.8% are adults, ages 18-64, and 14.1% of the population are seniors, 65 and over. The service area has a higher percentage of adults, ages 45-84, than the county.In the service area, 58.5% of the population is White, 26.9% are Hispanic/Latino, 8.8% are Black/African American, 2.2% are Asian, and the remaining 3.7% are American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, other race/ethnicity, or multiple races. There is a higher percentage of White Adventist Health Tehachapi Valley and Blacks/African Americans, and a lower percentage of Hispanic/Latinos and Asians in the service area than in the county. The languages spoken at home by area residents largely mirror the racial/ethnic make-up of the service area communities. While 26.9% of the area population is Hispanic or Latino, only 16.4% of the population speaks Spanish in the home. English is spoken at home by 80.5% of the population, and 2% of the population speaks an Asian or Pacific Islander language. 0.7% of the population speaks an Indo- European language in the home. In the service area, 9.5% of the population is foreign-born. Of the foreign-born, 55.5% are not citizens. |
| Part VI, Line 4 - Community Building Activities | The hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020 Adventist Health completed the acquisition of Blue Zones as the first step toward reaching this goal. By partnering with Blue Zones, we are able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint, and as we enter 2022 these projects are active. Blue Zones widens our impact from only reaching our hospitals communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. |
| Part VI, Line 5 - Promotion of Community Health | Our hospitals mission is, Living Gods love by inspiring health, wholeness and hope. Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the Triple Aim. The Triple Aim concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given todays state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthyeven though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population; 2) Factors that cause the present outcomes distribution; and 3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2) Improve care quality and patient safety, and 3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. |
| Part VI, Line 6 - Affilated Health Care System | The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. |
| Part VI, Line 7 - States Filing of Community Benefit Report | CA |
| Part VI - Additional Information | Identified Needs from CHNA, Not Addressed and Why (Based on 2020 (FY 2019) CHP Update) No hospital can address all the health needs identified in its community. Adventist Health Tehachapi Valley is committed to serving the community by adhering to its mission, and using its skills, expertise, and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed include the following: Mental health-need being addressed by others. Access to health care-need being addressed by others. Substance use and misuse-hospital does not have expertise to effectively address the need. Environmental pollution-hospital does not have expertise to effectively address the need. Sexually transmitted infections-needs being addressed by others. Unintentional injury-hospital does not have expertise to effectively address the need. Dental care/oral health-need being addressed by others. Birth indicators-insufficient resources (financial and personnel) to address the need. Alzheimers disease-need being addressed by others. Overweight and obesity-need being addressed by others. Other Items:In FY2021, Adventist Health Tehachapi Valley continued to take the following actions in response to the needs created or exacerbated by COVID-19: Continued to offer virtual health care visits to keep community members safe and healthy; continued with the online COVID symptom tracker; participated in communitywide efforts to vaccinate eligible community members. Additionally, Adventist Health Tehachapi Valley partnered with Kern County Public Health to provide free COVID-19 testing to the community, donated over 23,000 face masks to local and rural community-based organizations, senior centers, and social districts, initiated a COVID-19 vaccination program and expanded effort within the community. Primary website address: See Form 990, Pg. 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CA Hlth Fund & Trust | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 K St Ste 800 | AddressLine1Txt |
| City | Sacramento | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95814 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 941498697 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $50,650 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Valuation Method Used | Funds Transfer | ValuationMethodUsedDesc |
| Purpose Of Grant | Uninsured/Underinsured Patients | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Additional Supplemental Information | FormAndLineReferenceDesc |
| Explanation | Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (26 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Badders Brett | ||||||||||||
| Manager, RN | $351,805 | $75 | $5,570 | $357,450 | ||||||||
| Briggs Sharlet | ||||||||||||
| President thru 08/20 | $548,135 | $32,738 | $580,873 | |||||||||
| Butler David | ||||||||||||
| Pres eff 3/21 | $71,703 | $61,293 | $753,760 | $444,092 | $165,028 | $11,644 | ||||||
| Cantrell Misty | ||||||||||||
| Patient Care Executive | $27,761 | $82,915 | $498,651 | $316,697 | $57,037 | $14,241 | ||||||
| Chen Steven | ||||||||||||
| Former Finance Officer, CCR 2/20 | $81,414 | $62,145 | $853,478 | $515,000 | $183,275 | $11,644 | ||||||
| Cox Shane | ||||||||||||
| Treas/A Sec | $54,772 | $70,638 | $588,375 | $364,154 | $85,853 | $12,958 | ||||||
| Eller Jeff | ||||||||||||
| Vice Chair/AHTV | $20,413 | $22,996 | $1,123,134 | $531,828 | $547,897 | |||||||
| Ferch Wayne | ||||||||||||
| Former President, CCR thru 2/20 | $823 | $18,351 | $604,463 | $585,289 | ||||||||
| Guirguis Yehia | ||||||||||||
| Pharmacist | $186,002 | $9,469 | $201,924 | $6,453 | ||||||||
| Heinrich Kerry-CEO Elect1121 | ||||||||||||
| Director | $21,159 | $285,324 | $138,538 | $123,000 | $2,627 | |||||||
| Hofheins Todd | ||||||||||||
| CFO | $202,998 | $48,266 | $1,379,057 | $999,600 | $116,549 | $11,644 | ||||||
| Jahn Andrew | ||||||||||||
| President, Care Division | $203,978 | $61,293 | $1,921,620 | $1,044,420 | $600,285 | $11,644 | ||||||
| Jamaleddine Ghassan | ||||||||||||
| Medical Officer as of 08/21 | $66,528 | $3,359 | $186,351 | $116,077 | $387 | |||||||
| Jobe Meredith | ||||||||||||
| Secretary | $147,239 | $45,152 | $992,466 | $616,324 | $169,142 | $14,609 | ||||||
| Larsen David | ||||||||||||
| Finance Officer, CCR thru 4/19 | $107,819 | $55,606 | $944,007 | $567,118 | $201,820 | $11,644 | ||||||
| Lorenz Alida | ||||||||||||
| Director, RN | $163,980 | $15,600 | $37,239 | $232,518 | $7,835 | $7,864 | ||||||
| Malas Nisreen | ||||||||||||
| Supvsr, Pharmacy | $178,696 | $11,436 | $198,968 | $8,612 | $224 | |||||||
| Nahapetian Arby | ||||||||||||
| Care Division Chief Medical Officer | $135,635 | $66,658 | $1,136,415 | $700,000 | $222,478 | $11,644 | ||||||
| Reiner Scott | ||||||||||||
| CEO thru 12/21 | $27,026 | $50,774 | $3,002,506 | $1,801,000 | $1,112,062 | $11,644 | ||||||
| Reppert Joseph | ||||||||||||
| Former CFO/Asst Secr thru 8/19 | $179,119 | $11,442 | $190,561 | |||||||||
| Reynoso Hernandez R | ||||||||||||
| Former Medical Officer, CCR | $31,829 | $26,849 | $413,415 | $229,177 | $125,560 | |||||||
| Spenst Brett | ||||||||||||
| Care Division Finance Officer | $13,577 | $33,656 | $831,401 | $734,400 | $38,124 | $11,644 | ||||||
| Stevens Eric | ||||||||||||
| Care Division Operations Executive | $135,535 | $33,656 | $934,603 | $749,000 | $76 | $16,336 | ||||||
| Waterhouse Karla | ||||||||||||
| RN, House Supvsr | $180,754 | $1,000 | $3,523 | $197,620 | $6,248 | $6,095 | ||||||
| Wing Bill | ||||||||||||
| Dir/Asst Sec/VC | $26,446 | $64,578 | $2,535,301 | $1,440,800 | $991,833 | $11,644 | ||||||
| Wolcott Daniel | ||||||||||||
| Pres thru 3/21 | $104,330 | $61,293 | $1,005,216 | $601,280 | $226,669 | $11,644 | ||||||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | This Form 990, including all supporting schedules, was prepared by a public accounting firm, reviewed by the System Controller and market Finance Officer, and shared by electronic communication with the corporation's Board of Directors prior to filing. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president immediately.The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Copies for the officers and key employees' COIs are kept in their personnel files. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The Organization's Board of Directors has established a Human Performance Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. A hospital president has a maximum potential incentive of 30 or 35 percent of base salary based upon size and scope of hospital. (Incentive potential is industry norm) Other hospital executives have a maximum potential incentive of 25 to 30 percent of base salary. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | See Line 15a explanation. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Net Assets Released = -$104899 |
| Prior Period Adjustments | Prior Period adjustments were a result of cash balance correction and clean up of books due to prior period activities including debt service, capital expenditures, and other items. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Adventist Health SystemWest | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 953484589 | Integrated Health System | CA | 501(C)(3) | 10 | NA | false |
| Adventist Health Clearlake Hospital Inc | ||||||||||
| 15630 18th Avenue | Clearlake | CA | 95422 | 680395149 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Physicians Network | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 680357690 | Medical Foundation | CA | 501(C)(3) | 12b2 | Adventist Health SystemWest | false |
| Castle Medical Center | ||||||||||
| 640 Ulukahiki Street | Kailua | HI | 96734 | 990107330 | Hospital | HI | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| Feather River Hospital | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 941101228 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| The Fremont- Rideout Health Group | ||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 942917251 | Hospital | CA | 501(c)(3) | 12b2 | Stone Point Health | false |
| Glendale Adventist Medical Center | ||||||||||
| 1509 Wilson Terrace | Glendale | CA | 91206 | 951816017 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| Hanford Community Hospital | ||||||||||
| 115 Mall Drive | Hanford | CA | 93230 | 940535360 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Lodi Memorial Hospital Assn Inc | ||||||||||
| 975 So Fairmont Ave | Lodi | CA | 95240 | 941044474 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Northwest Medical Fdtn of Tillamook | ||||||||||
| 1000 Third Street | Tillamook | OR | 97141 | 930622075 | Hospital | OR | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Paradise Valley Hospital | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 951816034 | Discontinued Operations | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false |
| Portland Adventist Medical Center | ||||||||||
| 10123 SE Market Street | Portland | OR | 97216 | 930429015 | Hospital | OR | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Reedley Community Hospital | ||||||||||
| 372 Cypress Ave | Reedley | CA | 93654 | 453220509 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Rideout Memorial Hospital | ||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 941387866 | Hospital | CA | 501(c)(3) | 3 | Fremont Rideout Health Group | false |
| St Helena Hospital | ||||||||||
| 10 Woodland Road | St Helena | CA | 94574 | 941279779 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| San Joaquin Community Hospital | ||||||||||
| 2615 Chester Avenue | Bakersfield | CA | 93301 | 952294234 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Simi Valley Hospital & Health Care Svc | ||||||||||
| 2975 No Sycamore Drive | Simi Valley | CA | 93065 | 956064971 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Sonora Community Hospital | ||||||||||
| 1000 Greenley Road | Sonora | CA | 95370 | 941415069 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Stone Point Health | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 823763347 | Supporting Organization | CA | 501(c)(3) | 12b2 | Adventist Health SystemWest | false |
| Ukiah Adventist Hospital | ||||||||||
| 275 Hospital Drive | Ukiah | CA | 95482 | 941639901 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| United Com-Serve | ||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 943015356 | Skilled Nursing/Assisted Living/Hm Hlth | CA | 501(c)(3) | 12b2 | Fremont Rideout Health Group | false |
| Walla Walla General Hospital | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 910617726 | Hospital | WA | 501(C)(3) | 3 | Advenstist Health SystemWest | false |
| Western Health Resources | ||||||||||
| PO Box 61935 | Roseville | CA | 95661 | 953867863 | Home Care | CA | 501(c)(3) | 10 | Advenstist Health SystemWest | false |
| White Memorial Medical Center | ||||||||||
| 1720 Cesar E Chavez Avenue | Los Angeles | CA | 90033 | 952282647 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| Willits Hospital Inc | ||||||||||
| 1 Marcela Drive | Willits | CA | 95490 | 680108919 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Delano | ||||||||||
| PO Box 460 | Delano | CA | 93216 | 770258013 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Tulare | ||||||||||
| 869 North Cherry Street | Tulare | CA | 93274 | 832351753 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Mendocino Coast | ||||||||||
| 700 River Drive | Fort Bragg | CA | 95437 | 845174585 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Coast Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 619135 | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952037291 | EIN |
| Primary Activities | Wind down after sale of hospital | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AHSWest | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C-Corp | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Adventist Health SystemWest | ||
| e | $63,555,672 | Notes Payable |
| Adventist Health SystemWest | ||
| m | $6,660,761 | Operating Exp |
| Adventist Health SystemWest | ||
| o | $58,457 | Compensation |
| Adventist Health SystemWest | ||
| r | $18,568,952 | Cash Mgt Funds |